Print Print
CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.

Hypercholesterolaemia - familial - Management
What follow up is required?

For people with familial hypercholesterolaemia (FH) who have been discharged from specialist care:

  • Offer a regular structured review that is carried out at least annually.
    • Ask about symptoms of coronary heart disease (CHD).
      • In adults, consider a baseline electrocardiogram (ECG) if this was not carried out at diagnosis.
      • A low threshold for referral is recommended for evaluation for possible CHD symptoms.
    • Check medication adherence and ask about possible adverse effects.
    • Assess smoking status: offer smoking cessation advice and referral to a smoking cessation clinic, if necessary. See the CKS topic on Smoking cessation.
    • Check blood pressure.
    • Check fasting lipids and any other tests relevant to drug monitoring. See the section on Prescribing information in the CKS topic on Lipid modification - CVD prevention.
    • Consider checking blood glucose and renal function.
    • Consider whether any of the following are needed (see Management of adults with heterozygous FH):
      • Additional lifestyle measures.
      • Changes to cholesterol or blood pressure lowering medication.
      • Aspirin.
      • Referral to a specialist with expertise in FH.
    • Discuss any plans for pregnancy and needs for contraception. See Special considerations in women and girls.
    • Inquire about the progress of family cascade testing, and advise that untested relatives should seek medical advice.

© NHS Institute for Innovation and Improvement